Damaged intervertebral discs. Diagnostics & Therapy

The choice of treatment depends on the diagnosis.

To initiate the right treatment for intervertebral disc damage, a thorough diagnosis is necessary first.

To initiate the right treatment for intervertebral disc damage, a thorough diagnosis is necessary first.

Back pain when bending over, lifting or carrying: Damage to the intervertebral discs are due to wear and restrict daily life of people who are affected. Causes of the degenerative disease are often unfavorable posture or improper loading of the spine and weak torso muscles. To determin the exact cause of complaints and the degree of intervertebral disc degeneration, various diagnostic measures can be carried out, such as MRI or X-rays.

Depending on the nature and extent of the injury, the appropriate treatment can be selected. If the wear of the disc is still in an early stage, conservative treatment measures such as physical therapy or muscle building workout often can help to prevent further back pain.

If the discs are already severely damaged, spinal surgery is necessary. The defective discs are removed and replaced with spacers or an artificial disc.

 

Intervertebral disc damage. Diagnostics, therapy & treament

Diagnostics. Detection of intervertebral disc degeneration

MRI, the most important examination.

The most important diagnostic process is magnetic resonance imaging (MRI), through which information is gained about the wear and tear of the intervertebral disc and facet joints. It also enables the assessment of the spinal canal and the nerve channels and can either diagnose a slipped disc or exclude this.

X-rays are used to assess the bone structure and spine shape, as well as for excluding other diseases such as a tumour or a curvature of the spine. So-called functional images (bending forwards / bending backwards) show the spine's stability. Other investigative procedures such as computed tomography or examinations using contrast medium (discography, myelography) have no definitive role. To exclude osteoporosis, a bone density measurement is recommended.

 

Diagnostic pain blocks.

In order to find out the damaged intervertebral disc, the suspect area is injected with anaesthesia to block the pain. If this succeeds, then the trigger of pain is found.

In order to find out the damaged intervertebral disc, the suspect area is injected with anaesthesia to block the pain. If this succeeds, then the trigger of pain is found.

To identify a painful disc or a painful spinal joint, so-called diagnostic infiltrations are occasionally necessary. Here, under fluoroscopic control, a local anaesthetic is injected directly into the suspected painful structure in order to block the pain. If this is the case, it is therefore also verified that this anatomical structure – whether disc or facet joint - is indeed sensitive to pain or is causing it. This is called ‚semi-invasive‘ (i.e. minimally invasive) diagnostics.

Of course, other causes of back pain must be ruled out. Causes such as gynaecological or gastrointestinal disorders, tumours, inflammation, osteoporosis, fractures, etc.

 

Therapy. Treatment of intervertebral disc damage

Important measures: Pain relievers and muscle training.

Once pain has subsided, back and abdominal muscles must be strengthened.

Once pain has subsided, back and abdominal muscles must be strengthened.

In the first instance we treat painful damaged intervertebral discs in the Schön Kliniken by conservative methods – i.e. without surgery. Acute treatment of pain in our patients is top priority here. First choice therapy is a combination of pain relievers and muscle relaxants. After acute pain subsides, a return to normal activities, supported by regular muscle training is important. In any case unnatural postures to avoid pain should be avoided. We encourage and support our patients to lead an active life. Movement, strength training and back training can also prevent further problems in the case of damaged discs.

 

Surgery: Operation when pain persists.

If symptoms persist, then an operation can bring relief. The use of interspinous spacers brings relief to the disc. The spacers are inserted between the spinous processes of the vertebrae and press these apart. In this way more height is created for the affected intervertebral disc.

A method that has proved its worth in terms of enabling our patients to have a pain-free life is replacement disc surgery. The worn out or displaced disc is removed and a prosthesis („Cage&Idquo) made of titanium, plastic or autogenous bone is fitted into the created gap. The spinal column is also stabilised by the fixation of two adjoining vertebrae with a plate. In this area the spinal column is then stiff and is no longer mobile.

Operative methods will come into question only when conservative treatment measures have not led to a satisfactory outcome for the patient.

 

Rehabilitation after intervertebrac disc degeneration.

Rehabilitation in the case of intervertebral disc damage.

Aim of the rehabilitation of damaged discs is the strengthening of the back muscles as well as spine stabilization.

Aim of the rehabilitation of damaged discs is the strengthening of the back muscles as well as spine stabilization.

Following acute conservative treatment but especially after an operation, rehabilitation is a good idea. Here in particular the back muscles and tendons are strengthened and also the back's weight-bearing ability is increased little by little. In the back school patients undergo training to learn movements that are gentle on the discs so that they can remain free from pain and mobile at home too.

 

Damage to the intervertebral discs

Damaged intervertebral discs are often painful and blamed on wear and tear, occurring with the passage of time.

Damage to the intervertebral discs

Specialised clinics

These clinics and hospitals have doctors and therapists qualified in treating damage to the intervertebral discs and diseases of the spine.

Specialised clinics